Illness Anxiety Disorder

Illness anxiety disorder is a mental disorder characterized by a preoccupation with having or acquiring a serious, undiagnosed medical illness. Somatic symptoms are either not present or mild in intensity.

Criterion A

Preoccupation with having or acquiring a serious illness. 

Criterion B

Somatic symptoms are not present or, if present, are only mild in intensity. If another medical condition is present or there is a high risk for developing a medical condition (e.g. - strong family history is present), the preoccupation is clearly excessive or disproportionate.

Criterion C

There is a high level of anxiety about health, and the individual is easily alarmed about personal health status.

Criterion D

The individual performs excessive health-related behaviours (e.g. - repeatedly checks body for signs of illness) or exhibits maladaptive avoidance (e.g. - avoids doctor appointments and hospitals).

Criterion E

Illness preoccupation has been present for at least 6 months, but the specific illness that is feared may change over that period of time.

Criterion F

The illness-related preoccupation is not better explained by another mental disorder, such as somatic symptom disorder, panic disorder, generalized anxiety disorder, body dysmorphic disorder, obsessive-compulsive disorder, or delusional disorder, somatic type.



Specify whether:

  • Care-seeking type: medical care, including physician visits or undergoing tests and procedures, is frequently used.

  • Care-avoidant type: Medical care is rarely used.
  • Other medical conditions
    • The first differential diagnostic consideration is an underly ing medical condition, including neurological or endocrine conditions, occult malignancies, and other diseases that affect multiple body systems. The presence of a medical condition does not rule out the possibility of coexisting illness anxiety disorder. If a medical condition is present, the health-related anxiety and disease concerns are clearly disproportionate to its seriousness. Transient preoccupations related to a medical condition do not constitute illness anxiety disorder.
    • Health-related anxiety is a normal response to serious illness and is not a mental disorder. Such nonpathological health anxiety is clearly related to the medical condition and is typically time-limited. If the health anxiety is severe enough, an adjustment disorder may be diagnosed. However, only when the health anxiety is of sufficient duration, severity, and distress can illness anxiety disorder be diagnosed. Thus, the diagnosis requires the continuous persistence of disproportionate health-related anxiety for at least 6 months.
    • Somatic symptom disorder is diagnosed when significant somatic symptoms are present. In contrast, individuals with illness anxiety disorder have minimal somatic symptoms and are primarily concerned with the idea they are ill.
    • In generalized anxiety disorder, individuals worry about multiple events, situations, or activities, only one of which may involve health. In panic disorder, the individual may be concerned that the panic attacks reflect the presence of a medical ill ness; however, although these individuals may have health anxiety, their anxiety is typically very acute and episodic. In illness anxiety disorder, the health anxiety and fears are more persistent and enduring. Individuals with illness anxiety disorder may experience panic attacks that are triggered by their illness concerns.
    • Individuals with illness anxiety disorder may have intrusive thoughts about having a disease and also may have associated compulsive behaviours (e.g. - seeking reassurance). However, in illness anxiety disorder, the preoccupations are usually focused on having a disease, whereas in obsessive-compulsive disorder (OCD), the thoughts are intrusive and are usually focused on fears of getting a disease in the future. Most individuals with OCD have obsessions or compulsions involving other concerns in addition to fears about contracting disease. In body dysmorphic dis
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